Psychiatry Gone Astray

Editorial note: We follow up the Guilty post last week with a piece written by Peter Gotzsche that has caused a stir in Denmark and provoked some of the Danish professors he critiques to respond.

At the Nordic Cochrane Centre, we have researched antidepressants for several years and I have long wondered why leading professors of psychiatry base their practice on a number of erroneous myths. These myths are harmful to patients. Many psychiatrists are well aware that the myths do not hold and have told me so, but they don’t dare deviate from the official positions because of career concerns.

Being a specialist in internal medicince, I don’t risk ruining my career by incurring the professors’ wrath and I shall try here to come to the rescue of the many conscientious but oppressed psychiatrists and patients by listing the worst myths and explain why they are harmful.

Myth 1: Your disease is caused by a chemical imbalance in the brain

Most patients are told this but it is completely wrong. We have no idea about which interplay of psychosocial conditions, biochemical processes, receptors and neural pathways that lead to mental disorders and the theories that patients with depression lack serotonin and that patients with schizophrenia have too much dopamine have long been refuted. The truth is just the opposite. There is no chemical imbalance to begin with, but when treating mental illness with drugs, we create a chemical imbalance, an artificial condition that the brain tries to counteract.

This means that you get worse when you try to stop the medication. An alcoholic also gets worse when there is no more alcohol but this doesn’t mean that he lacked alcohol in the brain when he started drinking.

The vast majority of doctors harm their patients further by telling them that the withdrawal symptoms mean that they are still sick and still need the mediciation. In this way, the doctors turn people into chronic patients, including those who would have been fine even without any treatment at all. This is one of the main reasons that the number of patients with mental disorders is increasing, and that the number of patients who never come back into the labour market also increases. This is largely due to the drugs and not the disease.

Myth 2: It’s no problem to stop treatment with antidepressants

A Danish professor of psychiatry said this at a recent meeting for psychiatrists, just after I had explained that it was difficult for patients to quit. Fortunately, he was contradicted by two foreign professors also at the meeting. One of them had done a trial with patients suffering from panic disorder and agoraphobia and half of them found it difficult to stop even though they were slowly tapering off. It cannot be because the depression came back, as the patients were not depressed to begin with. The withdrawal symptoms are primarily due to the antidepressants and not the disease.

Myth 3: Psychotropic Drugs for Mental Illness are like Insulin for Diabetes

Most patients with depression or schizophrenia have heard this falsehood over and over again, almost like a mantra, in TV, radio and newspapers. When you give insulin to a patient with diabetes, you give something the patient lacks, namely insulin. Since we’ve never been able to demonstrate that a patient with a mental disorder lacks something that people who are not sick don’t lack, it is wrong to use this analogy.

Patients with depression don’t lack serotonin, and there are actually drugs that work for depression although they lower serotonin. Moreover, in contrast to insulin, which just replaces what the patient is short of, and does nothing else, psychotropic drugs have a very wide range of effects throughout the body, many of which are harmful. So, also for this reason, the insulin analogy is extremely misleading.

This is probably the worst myth of them all. US science journalist Robert Whitaker demonstrates convincingly in “Anatomy of an Epidemic” that the increasing use of drugs not only keeps patients stuck in the sick role, but also turns many problems that would have been transient into chronic diseases.

If there had been any truth in the insulin myth, we would have expected to see fewer patients who could not fend for themselves. However, the reverse has happened. The clearest evidence of this is also the most tragic, namely the fate of our children after we started treating them with drugs. In the United States, psychiatrist collect more money from drug makers than doctors in any other specialty and those who take most money tend to prescribe antipsychotics to children most ofter. This raises a suspicion of corruption of the academic judgement.

The consequences are damning. In 1987, just before teh newer antidepressants (SSRIs or happy pills) came on the market, very few children in the United States were mentally disabled. Twenty years laterm it was over 500,000, which represents a 35-fold increase. The number of disabled mentally ill has exploded in all Western countries. One of the worst consequences if that the treatment with ADHD medications and happy pills has created an entirely new disease in about 10% of those treated – namely bipolar disorder – which we previously called manic depressive illness.

Leading psychiatrist have claimed that it is “very rare” that patients on antidepressants become bipolar. That’s not true. The number of children with bipolar increased 35-fold in the United States, which is a serious development, as we use antipsychotic drugs for this disorder. Antipsychotic drugs are very dangerous and one of the main reasons why patients with schizophrenia live 20 years shorter than others. I have estimated in my book, ‘Deadly Medicine and Organized Crime’, that just one of the many preparations, Zyprexa (olanzapine), has killed 200,000 patients worldwide.

Myth 5: Happy pills do not cause suicide in children and adolescents

Some professors are willing to admit that happy pills increase the incidence of suicidal behavior while denying that this necessarily leads to more suicides, although it is well documented that the two are closely related. Lundbeck’s CEO, Ulf Wiinberg, went even further in a radio programme in 2011 where he claimed that happy pills reduce the rate of suicide in children and adolescents. When the stunned reporter asked him why there then was a warning against this in the package inserts, he replied that he expected the leaflets would be changed by the authorities!

Suicides in healthy people, triggered by happy pills, have also been reported. The companies and the psychiatrists have consistently blamed the disease when patients commit suicide. It is true that depression increases the risk of suicide, but happy pills increase it even more, at least up to about age 40, according to a meta-analysis of 100,000 patients in randomized trials performed by the US Food and Drug Administration.

Myth 6: Happy pills have no side effects

At an international meeting on psychiatry in 2008, I criticized psychiatrists for wanting to screen many healthy people for depression. The recommended screening tests are so poor that one in three healthy people will be wrongly diagnosed as depressed. A professor replied that it didn’t matter that healthy people were treated as happy pills have no side effects!

Happy pills have many side effects. They remove both the top and the bottom of the emotions, which, according to some patients, feels like living under a cheese-dish cover. Patients care less about the consequences of their actions, lose empathy towards others, and can become very aggressive. In school shootings in the United States and elsewhere a striking number of people have been on antidepressants.

The companies tell us that only 5% get sexual problems with happy pills, but that’s not true. In a study designed to look at this problem, sexual disturbances developed in 59% of 1,022 patients who all had a normal sex life before they started an antidepressant. The symptoms include decreased libido, delayed or no orgasm or ejaculation, and erectile dysfunction, all at a high rate, and with a low tolerance among 40% of the patients. Happy pills should therefore not have been marketed for depression where the effect is rather small, but as pills that destroy your sex life.

Myth 7: Happy pills are not addictive

They surely are and it is no wonder because they are chemically related to and act like amphetamine. Happy pills are a kind of narcotic on prescription. The worst argument I have heard about the pills not causing dependency is that patients do not require higher doses. Shall we then also believe that cigarettes are not addictive? The vast majority of smokers consume the same number of cigarettes for years.

Myth 8: The prevalence of depression has increased a lot

A professor argued in a TV debate that the large consumption of happy pills wasn’t a problem because the incidence of depression had increased greatly in the last 50 years. I replied it was impossible to say much about this because the criteria for making the diagnosis had been lowered markedly during this period. If you wish to count elephants in Africa, you don’t lower the criteria for what constitutes an elephant and count all the wildebeest, too.

Myth 9: The main problem is not overtreatment, but undertreatment

Again, leading psychiatrists are completely out of touch with reality. In a 2007 survey, 51% of the 108 psychiatrists said that they used too much medicine and only 4 % said they used too little. In 2001–2003, 20% of the US population aged 18–54 years received treatment for emotional problems, and sales of happy pills are so high in Denmark that every one of us could be in treatment for 6 years of our lives. That is sick.

Myth 10: Antipsychotics prevent brain damage

Some professors say that schizophrenia causes brain damage and that it is therefore important to use antipsychotics. However, antipsychotics lead to shrinkage of the brain, and this effect is directly related to the dose and duration of the treatment. There is other good evidence to suggest that one should use antipsychotics as little as possible, as the patients then fare better in the long term. Indeed, one may completely avoid using antipsychotics in most patients with schizophrenia, which would significantly increase the chances that they will become healthy, and also increase life expectancy, as antipsychotics kill many patients.

How should we use psychotropic drugs?

I am not against using drugs, provided we know what we are doing and only use them in situations where they do more good than harm. Psychiatric drugs can be useful sometimes for some patients, especially in short-term treatment, in acute situations. But my studies in this area lead me to a very uncomfortable conclusion:

Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good. Psychiatrists should therefore do everything they can to treat as little as possible, in as short time as possible, or not at all, with psychotropic drugs.

Friday, January 17, 2014

ONE MILLION!

My hits went over the one million mark a short while ago. My original Blogger counter went from 999,999 to 100,000 at around 11.30am UK time. I think Blogger counters only have 6 digits so I’ve just installed a new counter.

A few thanks must go out to the following…

Dad – His sense of pride in me has kept my feet firmly on the ground. – I salute you

Mom – You passed on that old Irish stubbornness, I hope you are still throwing those bricks. – I salute you

My sisters, Deb and Jan. There may have been times when I’ve appeared frustrated and distant. Thanks for standing by me and showing your support.

My boys – Danny, Marc and Gary – Collectively you are alive in me. Part of you all has become the writer.

Benn – My four-legged friend, thank you for the walks and the company when I was mulling things over. – I salute you

CCHR International, UK, and Canada – These guys rock and they honoured me a few years back with a couple of awards. I met people because of them. I travelled because of them. I learned that this wasn’t just about Seroxat and withdrawal. It was about many other antidepressant type medications. Marla, Jan, Lori, Margaret, Sue & Brian, for showing me how to flourish as a writer, as a human. CCHR still rock, they still honour the men and women on the street, normal people, like you and me. – I salute you

Rob Robinson – The Godfather of Paxil activists. You kicked some serious ass my friend. Thank you. – I salute youDavid Healy – An inspiration and not a maverick. – I salute you

Shelley Jofre – The BBC’s own ankle-biter who has investigated GSK, the MHRA and Seroxat on four separate occasions. She kept the fire going in my belly. – I salute you

Baum, Hedlund, Aristei & Goldman – Top US Attorneys with a great track record against GlaxoSmithKline. I will live forever in your debt. Gary, Rob, Ash, Foz, Mo, Peggy, Liz, Twyla, Michael, Leemon, Cindy – I salute you

The Dixie Chicks, without whom I wouldn’t be here. They, unknowingly, helped me through severe Seroxat withdrawal. – I salute you

Sarah-Jane Richards – For the many chats over the phone, for giving me hope, for showing me what tenacity and doggedness are all about. – I salute you

Evelyn Pringle – Investigative journalist who had a real influence on me with her work on the early Paxil cases. – I salute you

Stuart and the late Claudette Jones – A Christmas present every year, you never forgot. Much love to you both. – I salute you

Chipmunka Publishing – For having the balls to publish my book. – I salute you

To all bloggers past and present – you have all been part of my journey. – I salute you

GlaxoSmithKline and their Attorneys – For spectacularly giving me stories to write. As long as you keep messing up, I’ll keep writing. – Middle finger salute to you

There are many, many more people I’d like to thank, the list is endless, you all know who you are. – I salute you

A huge thank you to you, the readers. Thank you for your support over the past 8 years. Thank you for coming back time and time again. – I salute you

This post is dedicated to every single man, woman and child [including fetuses] who have lost their lives because of the side effects of SSRi medication. – I salute you.

I salute you all.

The year ahead is looking pretty damn good. Time to stretch those legs.

GRAND RAPIDS (WZZM) — The body of Bob Farthing was found in the back of his vehicle by family members. His daughter says it was parked at a hotel on the East Beltline.

Farthing, 78, travelled from Flint with his wife on Wednesday. Police say he dropped her off to Spectrum Butterworth to visit a patient and said he was going to a nearby restaurant for some food. He never returned to pick her up.

“He would never, ever have disappeared, he would have never taken off and left my mother like this,” said Denise Shaheen, Farthing’s daughter. She says there is only one explanation for the disappearance.

“He is struggling with the withdrawal from the drug Paxil.”

After using the antidepressant for 15 years, his family says doctors were weaning Farthing off of the powerful drug and putting him on other medicine. But it was a difficult process.

“He would have a couple good days, he would have a couple bad days. His bad days were very bad days,” said Shaheen. “He became very depressed, very confused.”

Wednesday was a bad day for Farthing; he dropped his wife off at Butterworth Hospital around noon so she could visit a relative. But he didn’t come back to pick her up, he didn’t answer his phone or text messages.

Farthing was found by police Friday night in the back seat of his 2005 Buick Lacrosse. His cause of death is not known at this time.

This month in 2000: The formation of GSK

The twenty-first century’s first ‘mega merger’

GSK may be among the most well-known three letters in healthcare today, transcending the pharma industry to become an established name in the minds of consumers across the world.

It’s a struggle to think then that this abbreviation has only been around for 14 years, when Glaxo Wellcome and SmithKline Beecham merged to become one of big pharma’s biggest members – GlaxoSmithKline.

Since then, GSK has been consistently one of the world’s best-performing healthcare companies, led by such prescription drugs as asthma treatment Advair/Seretide (fluticasone/salmeterol) and the antidepressant Seroxat/Paxil (paroxetine), as well as a strong vaccines business and a consumer division that until recently included the drinks Lucozade and Ribena.

This success has arguably lived up to the industry excitement on January 17, 2000, when the world woke up to the news that two companies had agreed the UK’s largest ever corporate merger to become what GSK’s first press release described as the ‘world’s leading research-based pharmaceutical company’.

The deal was not unexpected, however, as both Glaxo Wellcome – a prescription-drug focused firm based in London – and SmithKline Beecham – a fellow UK company with more of a focus on consumer health and OTC products – had been contemplating a merger for some time.

Unification was initially suggested in January 1998, with an Economist report at the time describing the deal as the ‘mother of all mergers’.

‘The new firm’s share of the world drug market, at 7.5 per cent, would tower over Merck’s 4.5 per cent and Novartis’ 4.3 per cent. Its research budget would be equivalent to a quarter of total private-sector R&D spending each year in Britain. And it would boast a market capitalisation of over £100bn ($165bn), making it the second-largest company in the world after America’s General Electric,’ the publication excitedly proclaimed.

The prospect of this merger also put a dampener on the attempts by US drug company American Home Products (later known as Wyeth Pharmaceuticals, which was acquired by Pfizer in a major deal in 2009) to merge with SmithKline Beecham in a deal that would make it the world’s biggest pharma company.

However, this 1998 deal between Glaxo Wellcome and SmithKline Beecham was shelved just one month later after discussions between the two companies collapsed due to “insurmountable differences” on how the new company would be managed.

According to the BBC, this was because Jan Leschly, CEO of SmithKline Beecham – and former pro tennis player – was “unwilling to play second fiddle to Glaxo’s dynamic chairman, Richard Sykes” when it came to running the new company.

Evidently, despite the breakdown of this deal, discussions between the two companies remained ongoing, with the announcement in January 2000 spurred by two key incidents.

First, SmithKline Beecham’s CEO Leschly announced at the end of 1999 his decision to retire from the company the following year, paving the way for the company’s chief operating officer Jean-Pierre Garnier to take over leadership at the company.

And second of all, the US drug firm Warner Lambert announced it had abandoned its merger plans with American Home Products – the former suitor of SmithKline Beecham – to accept a takeover deal from US pharma company Pfizer to create a global drug giant.

According to the BBC in an article about the formation of GSK: ‘Not wanting to be overshadowed, Glaxo and SmithKline decided to accelerate their merger schedule.’

With the prospect of more receptive new leadership at SmithKline and a desire to stay ahead of a competitive industry fuelled by mergers – Astra and Zeneca and Sanofi and Synthélabo had also recently announced plans to join forces – a deal that suited both sides was carved out, eventually being completed by December 2000.

As for who would lead the newly-formed GSK, it was a joint effort between the two constituent parts, with Jean-Pierre Garnier at the management helm as CEO of and Sir Richard Sykes taking on the role of non-executive chairman.

Sykes would remain in his role for two more years, before retiring from industry to take on an academic pursuit as rector of Imperial College London.

Garnier held the CEO role until 2008, leading the company as it acquired Block Drug in a deal worth $1.24bn; relocated to GSK House in Brentford; and made its first R&D moves into China among other achievements.

After Garnier’s departure to become CEO of Pierre Fabre Labs, the company’s European head Sir Andrew Witty took on the top job – a role he continues to hold, overseeing the company during perhaps its most challenging years facing billion dollar lawsuits in the US and corruption allegations in China, but also spear-heading pharma moves towards clinical trial transparency.

GSK has come a long way since 2000, and who knows what it or the rest of the industry will look like in another 14 years.

Like this:

Started just a year ago, AntiDepAware is a website which aims to research and document cases of suicide, homicide, and murder-suicides (where anti-depressants are a possible contributing factor) in the UK and Wales. By collecting newspaper reports and coroners reports this website paints a startling picture of the dire state of mental health treatment in the UK.

Brian has done a great job here and no doubt this site will be a great resource for further study into anti-depressant induced suicides and related issues. The evidence that Brian has collected here really speaks for itself. Brilliant website and great resource. Well done Brian.

Welcome to AntiDepAware

The objective of this site is to promote awareness of the dangers of antidepressants.

There is no wish to ban these drugs which give support to a large number of people with depression. However, it is clear that antidepressants are being prescribed to those who are not depressed, to whom they are likely to do more harm than good.

In 2009 my son, who had never been depressed in his life, went to see a doctor over insomnia caused by temporary work-related stress. He was prescribed Citalopram, and within less than a week he had taken his life.

As a consequence I learned of the suicide risk of antidepressants, particularly in the early weeks of uptake or if the dosage is changed up or down, or withdrawn.

Drug companies will say that an adverse reaction which induces suicidal thoughts will affect only about 1% of users. But there are at present over 4 million users of antidepressants in the UK, which means that there are 40 thousand people who may be at risk at one time or another.

The centrepiece of this site is a link to inquest reports, found mostly in the online archives of local newspapers, in which antidepressants are a factor in self-inflicted deaths. The reports cover England and Wales over the past 10 years.

It must be noted that this list is far from exhaustive but, even so, contains exactly 1650 reports, including 263 (or an average of 5 a week) from 2012 alone.

My motivation in embarking on this research has been to offer some understanding to the grieving families who are invariably left a legacy of unanswered questions, along with the memory of horrific loss. Perhaps this site will help answer some of those questions.

Brian

WARNING: People who have been prescribed antidepressants should never suddenly stop taking their medication. Gradual tapering is advisable. Anyone considering altering the dosage of their medication, or withdrawing from it, needs to take medical advice first.

Antidepressant regulations tightened following suicide

A doctor has been found responsible for the suicide of his 20-year-old patient

The health agency, Sundhedsstyrelsen, has decided to make it harder for doctors to prescribe antidepressants to 18-to-24-year-olds after the suicide of a young man, TV2 News reports.

Danilo Terrida, 20, committed suicide in 2011, eleven days after he was prescribed antidepressants following an eight-minute-long conversation with a doctor.

The doctor never followed up on the consultation and has now been found responsible for the suicide by the National Agency for Patients’ Rights and Complaints.

Harder to get ‘happy pills’

From now on, young patients will have to face an assessment and an in-depth conversation with a doctor before antidepressants can be prescribed.

“Along with the Danilo case, there have been other cases that we, as the oversight authority, are not satisfied with. That is why we are now tightening the rules for this vulnerable group,” Sundhedsstyrelsen spokesperson Anne Mette Dons told TV2 News.

Terrida’s family said that they were pleased that the rules had been tightened for prescribing antidepressants.

“It doesn’t change the fact that we have lost our son,” Danilo’s mother, Marianne Terrida, told Jyllands-Posten newspaper. “The fact that it’s a dangerous drug is not new, it’s been known a long time.”

Researcher: Medication counter-productive
The case has sparked a debate about the dangers of psychiatric drugs, and in Politiken newspaper today Peter Gøtzsche, medical researcher and leader of the Nordic Cochrane Center at Copenhagen’s Rigshospitalet, wrote that antidepressants have caused healthy people to commit suicide.

“It is true that depression increases the risk of suicide, but antidepressants increase it even more, at least up until the age of 40,” he wrote.

“Doctors cannot cope with the paradox that drugs that can be useful for short-term treatment can be highly dangerous when used for years and even create the illnesses that they were supposed to prevent, or even bring on an even worse illness,” Gøtzsche wrote.

The BMJ no longer publishes research funded by tobacco companies. Richard Smith and Peter Gøtzsche say that research funded by drug companies is also flawed and published to encourage sales, but Trish Groves says that the industries are fundamentally different and that moves are afoot to increase integrity

Yes— Richard Smith and Peter C Gøtzsche

The BMJ and its sibling journals have stopped publishing research funded by the tobacco industry for two main reasons: the research is corrupted and the companies publish their research to advance their commercial aims, oblivious of the harm they do.1 But these arguments apply even more strongly to research funded by the drug industry, and we suggest there is a better way to communicate the results of trials that would be safer for patients.

Prescribed drugs are the third leading cause of death, partly because of flaws in the evidence published in journals. We have long known that clinical trials funded by the drug industry are much more likely than publicly funded trials to produce results favourable to the company.2 The reason is obvious. The difference between an honest and a less than honest data analysis can be worth billions of euros, and the fraudulent trials of some cyclo-oxygenase-2 inhibitors for arthritis and selective serotonin reuptake inhibitors for depression are good examples.3 4 5

Industry cannot be trusted

There are many clever ways in which companies manipulate their research,6 and two recently published books give dozens of examples.3 7 Flaws in the coding of adverse events can distort results without leaving any trace of what has happened, as we cannot get access to the raw data the drug companies hold. Three large trials of prasugrel, rosiglitazone, and ticagrelor made by Daiichi Sankyo and Eli Lilly, GlaxoSmithKline, and AstraZeneca, respectively, published in the New England Journal of Medicine were shown to be …

GSK must learn from some tough medicine

WE have been so overwhelmed in this country by the proliferation of scandals that we probably haven’t noticed that it is happening elsewhere, too.

We’re saving more — even though it’s giving us much less in return

Number of regular savers increased in December – new data

AIB offers storm victims breathing room on loans

Over the past few years we have seen a chorus of outrage against a number of pharma companies, including Wyeth, Eli Lilli and Johnson & Johnson.

All have had their knuckles rapped and pockets emptied by hefty fines. In the past four years, the industry has had to shell out an amazing $13bn in payments to the authorities for not sticking to the rules.

However, the biggest of these recent pharma scandals — and the one that drew the largest fine — involved the UK drug giant Glaxo Smith Kline (GSK). The fine was $3bn; the largest ever imposed on any drug company. Having offended one superpower (the US) the company proceeded to offend another (China), which was downright careless.

This year, the Chinese government accused GSK of using a network of travel agencies to channel bribes worth $500m to Chinese doctors, hospitals and government officials.

To cope with the fallout, GSK recently announced it was scrapping sales targets to prioritise “the interests of patients”. The public relations expert who dreamt up that excuse should go back to PR school.

GSK has been across my investment radar for many years and I’d have expected a far superior degree of professionalism.

It is, of course, big enough to be taught a lesson. It employs 100,000 across 150 countries with 87 manufacturing and R&D sites, including three sites in Ireland. The company is structured around three divisions; prescription medicines, consumer health products and vaccines.

Prescription medicines is the largest division, with sales of £18bn (68pc of group sales). Its consumer health products division accounts for £5bn of group sales, having its focus on oral care and over-the-counter medicines like Panadol, and also includes skin care, following its acquisition of Stiefel for $3bn.

Vaccines, of which GSK produces 30, including diphtheria, tetanus and hepatitis, account for £3bn in sales. Group sales last year were £26bn and operating profits were £3bn. The US is GSK’s largest market with sales of £8bn, followed by both Europe and emerging markets with sales of £7bn.

But its business is shifting to growth markets like Asia/Pacific and Latin America and the territories outside the US and Europe now account for 40pc of group sales. One of the reasons why GSK has been across my radar is because of its generous dividend policy. It returned £25bn in dividends and buy-backs to shareholders in the past five years and continues to pledge its commitment to higher payouts — good news for income investors.

The firm has a market value of £77bn and its share price of £15.98p is down from a yearly high of £18.16 recorded this year. GSK will bear close attention in the coming years as it deals with the reshaping of its US and European businesses.

Its impressive R&D programme (£3bn in 2012) should help. And like all giants of its size, cost control is high on the agenda. But transparency is now vital; pharma regulators have begun to bite.

NOTHING PUBLISHED IN THIS SECTION SHOULD BE TAKEN AS A RECOMMENDATION, EITHER IMPLICIT OR EXPLICIT, TO BUY OR SELL ANY OF THE SHARES MENTIONED.